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Brandeis University's Community Newspaper — Waltham, Mass.

Pediatric care worth sticking with

Published: September 28, 2012
Section: Opinions

I recently found myself sitting in a waiting room at a doctor’s office. The floor had a fun patterned carpet, there were puzzles scattered around and “Finding Nemo” played on a flat screen, while a clown with a balloon was staring at me from his portrait across the room.

So often today, we are in a rush to grow up. There is a stigma associated with being a child, one that as we grow older and leave pubescence, morph into teenagers, and then begin to tell people we are in our “early twenties” we try to leave behind. Most pediatric doctors allow college students to stay-on as their patients until they graduate, but so often, as we hurry toward becoming an adult, too quickly we leave our pediatric doctors behind.

We may, however, make this decision in haste. It is indisputable that children are treated with more care when it comes to facing illness or general well-being while in pediatric care than an adult facing a similar issue. In a New York Times article published in March, Dr. Bradley Monash, who works in both the pediatric and adult wards at a hospital in California, was quoted saying, “There’s something about the care of a child that touches people. There’s something about caring for children that people address differently.”

Comparing the adult to the children’s wards in the hospital is illustrative of the differences in care. Dr. Monash commented that within pediatric care, family members are better accommodated. Cots are built into pediatric hospital rooms because it is expected that parents will spend the night with their child. Parents are allowed into recovery rooms, while in the adult section, it is harder for family members and friends to have access to the recovering patient. There aren’t “visiting hours where everyone has to leave.” Dr. Perry Klass, the author of The Times article, asks a good question when he points out the differences in adult and pediatric care. While we treat children with more fragility and concern than adults, “are adults any less scared, uncertain or disoriented?” The answer is no.

The idea that once you hit a certain age, you are able and therefore forced to handle more fear is inaccurate and wrong. As I recover from a surgery, no matter if I am seven, 12 or 44, I will want a comforting face to greet me as I regain consciousness. I think that this is true for most people.

It isn’t always easy seeing a pediatrician. Often times you’ll find that your nearest companion is a grumpy seven year old and the nurse asking you awkward questions is dressed in Bernstein Bears scrubs. But at the end of the day, these trivial things do not diminish the fact that the quality of care you receive is significantly greater than an adult practitioner.

The difference in care can be explained because there is a goal for pediatric doctors that is nonexistent in doctors for adults. As was recently explained to me, the goal of pediatricians of any type, be it a primary care physician (PCP), a gastroenterologist or a cardiologist, is to do whatever they can to provide the child they are seeing with the ability to grow up healthy and happy. That mantra doesn’t exist in adult care where the impetus is on the patient to be an advocate for their health needs and there is no end goal in sight. In pediatrics, because there is an impending deadline (once that child has graduated college or is 18, depending on preference) the doctors want to see that when their patients leave their care, they do so with the best results— as a thriving young adult. This often times induces pediatric doctors to be more flexible. They are willing to spend more time explaining diagnoses and consequences to their patients. In pediatric care, you don’t feel like a cog in the system.

The transition from pediatric care to adult care can often be difficult. The kind of extensive and kind care received during childhood falls away as a young adult is integrated into the adult medical world, where they often receive “very minimal care that really is much more haphazard and not nearly as comprehensive as the care they had when they were children,” Dr. Debra Lotstein, an assistant professor of pediatrics at the University of California tells Dr. Klass.

The conclusion to a study by the Commonwealth Fund released in May of 2011 found that in 2009, a third of the 19 to 29-year-olds in America had no insurance coverage, limiting their medical care options. Hopefully the implementation of President Obama’s Affordable Care Act, which allows children to stay on their parent’s health insurance plan until they turn 26, will reduce this astronomical number and frightening statistic.

So while we work hard to attain our college degrees and move out into the big world, something we need not get rid of before we absolutely have to should be pediatric care. Although you will have to put up with the childish waiting rooms, Shrek band aids and the snotty four-year-old throwing a tantrum in the exam room next door, sometimes, it’s best to be considered a “child” for as long as possible.